1. Field of the Invention
The invention relates to a corset for the treatment of a patient suffering from a back complaint, such as scoliosis, comprising a lower part to be supported by the hip, and an upper part to be fitted around the patient""s chest.
2. Description of the Related Art
The corset may be applied for various kinds of complaints, but for the sake of clarity it will be discussed in relation to scoliosis.
A corset of this kind is known, for instance, from the European patent application EP-A-0 234 372. The corset known from this publication is comprised of relatively rigid elements and forces the patient into a particular posture. In order to allow the patient some freedom of movement, a removable connecting element is provided between the lower part and the upper part. The known corset applies stationary pressure forces to the patient""s body in order to stabilize and, if possible, to correct the scoliosis.
From DE-A-66,593 a corset is known comprising a lower part and an upper part which are interconnected in three places. The connecting elements comprise a band of spring steel, a steel element in the form of a horse shoe, and a pressure spring. The construction aims to provide the wearer of the corset with a permanent support and rotational pressure. However, the construction of this corset locks the patient into a rather tight straitjacket.
With regard to the working of the known corset, several theories exist which, briefly, amount to the following. In a first theory the body of the patient is stimulated to withdraw from the unpleasant feeling of the corset. To allow room for this, the known corset is provided with openings opposite to places where pressure is exerted on the patient""s body. Another theory is that the corset produces an elastic deformation of the patient""s body which with time will become a permanent correction.
Anyway, the known corset has a number of disadvantages obstructing effectiveness. As mentioned above, the known corset is rigid, resulting in poor wearing comfort. For this reason the known corset is usually only employed with the more serious forms of scoliosis. It is precisely these more serious forms of scoliosis that are less suitable for correction by means of a corset. The best result to be achieved with the known corset in such a case is stabilization of the scoliosis. Therefore, a need exists for a corset which is more comfortable in wear so that it invites usage even with lighter forms of scoliosis, whereby wearing the corset can become more effective.
A further disadvantage of the known corset is that because of the construction being so rigid, the patient runs the risk of hanging in the corset. The muscles are used less, especially since for the corset to be effective it must be worn at least 23 hours a day. The consequential weakening of the muscles is counterproductive with respect to the use of the known corset, in the sense that this may result in the worsening of the scoliosis. Yet another disadvantage of the known corset is that due to the rigid construction the corrective forces decrease, as the scoliosis improves. This requires constant adjustment of the known corset if the scoliosis is to be treated fully.
Still another disadvantage of the known corset is that the lower part is fitted so closely and even clasping the pelvic region so tightly that it causes pain.
Still another disadvantage of the known corset construction is that it forces the patient into so unnatural a posture, that it becomes obvious to others, which from a psychological viewpoint has a negative influence on the willingness to start wearing a corset.
The object of the invention is now to remove these disadvantages. To this end the corset according to the invention is characterized in that a flexible coupling is provided to connect the lower part and the upper part. This flexible coupling allows the patient to move relatively freely even when wearing the corset according to the invention, improving the wearing comfort with the result that the willingness to actually wear the corset is positively influenced. This takes away the objections to wearing the corset also with lighter forms of scoliosis, thus allowing optimal exploitation of the efficacy of the corset""s corrective action.
In a further aspect of the invention the corset is equipped such that both the lower part and the upper part are provided with an adjustable springy element to enable the lower part and the upper part to apply a pressure force on the patient""s body. The springy element may be an adjustable elastic band. This increases the efficacy and functionality of the corset because the forces the corset exerts on the patient""s body are thus made independent of the extent of correction of scoliosis being realized at any given moment during wear of the corset. Especially this advantage of the corset according to the invention distinguishes it decisively from the known corset.
The corset according to the invention should then be executed such that the springy element of the lower part is provided at the point where the lower part rests on the patient""s pelvis, and that at the height of the patient""s lumbar region, the lower part further comprises a support plate coupled with the springy element, which support plate is preferably also a springy element.
As mentioned, the support plate is located at the height of the scoliotic complaint, in the lumbar region of the back. Due to its customary s-form, the scoliosis frequently spans the entire back. The scoliosis in the upper back often becomes visible through the development of a gibbus (deformation of the ribs). A kind of gibbus also often appears in the lumbar region, due to a slight protrusion of the bundle of muscles at the convex side of the scoliosis. A corrective force is applied to both gibbuses. Even in the cases where the lumbar region does not exhibit any scoliosis, it is still necessary to apply a force to prevent that, as a result of correction of the upper region, a new curve develops in the lumbar region. The force exerted on the lumbar region has to prevent this.
Further, it is desirable that the springy element of the upper part is provided at the height of the scoliosis to be corrected and at the same side as the springy element of the lower part.
To properly distribute the forces to be applied to the patient""s body, the upper part should further be provided with a pressure plate under the patient""s armpit at the side opposite the springy element of the upper part, which pressure plate during wear is located somewhat higher than said springy element.
Finally, the upper part must be provided with at least one pressure plate at the height of the patient""s sternum.
A simple embodiment for the realization of the flexible coupling is the embodiment using a hinged coupling. A particularly advantageous embodiment is the one in which the flexible coupling comprises a bar-like part and a sleeve-like part, with the bar-like part being at least to some extent slidable in the sleeve-like part, and the bar-like part and the sleeve-like part being attached to the lower part and the upper part, without both being attached to the same part. This embodiment very simply allows the patient to move his chest in relation to the pelvis both lengthways and sideways. It also makes it possible to turn the thorax in relation to the lower part of the body. In a particularly effective manner said embodiment affords the patient a mobility and wearing comfort not much inferior to the situation in which the corset is not required. In addition it is desirable, that a flexible connection is provided, for instance a light chain, for coupling the upper part with the lower part to prevent the corset from falling apart when putting it on and taking it off.
In this respect the corset according to the invention is very effective if only one single coupling is provided at the height of the patient""s side.
A relatively open and therefore easily wearable and inconspicuous embodiment of the corset is characterized in that both the lower part and the upper part are substantially formed by a brace which together with the springy element, can surround the patient""s body.
With the corsets of the prior art the pressure plates are rigidly attached to the corset. In a further aspect of the corset according to the invention the pressure plates are joined with the brace by means of a ball and socket joint, whereby said pressure plates at the side facing the brace are provided with a bulge fitting into a hollowing in a hinge element being a part of or being attached to the brace. The bulge may be attached to each pressure plate as separate part, or may be integrated by means of a local deformation of the pressure plate. Each pressure plate is kept in place by means of an O-ring. The O-ring ensures that after being relieved of pressure, the pressure plate returns to its original position. The construction works as a restrictive ball and socket joint, so that the pressure plates follow the form of the patient. In this way the direction of the forces is always perpendicular to the skin. There are no shearing forces which could cause pain or even injuries. Furthermore, the construction is very flat to prevent the corset from being visible under the clothing.
Exclusive rights are also requested for the corset""s separate lower part and upper part respectively; said separate parts may be very usefully applied for the correction of certain forms of scoliosis.